Polyaxial dental implant system

ABSTRACT

A dental implant system is described, including a lower implant body configured to be implanted in bone, and an upper implant body that couples to the lower body, thereby forming a cavity between upper and lower bodies. The system can further include a rotatable, swivelable anchor having a base at least partially disposed within the cavity. The anchor may have a shaft coupled to the base and extending through an opening in the upper body. The system may also include an abutment that couples to the shaft of the anchor and serves as a mounting area for a crown. The anchor&#39;s rotatability and swivelability allow the lower implant body to be implanted at an angle in bone while permitting the crown to be positioned in a natural tooth orientation.

RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.13/447,121, filed on Apr. 13, 2012, which claims the priority benefit ofU.S. Provisional Applications No. 61/476,230, filed on Apr. 15, 2011,No. 61/487,591, filed on May 18, 2011, No. 61/512,366, filed on Jul. 27,2011, and No. 61/545,061, filed on Oct. 7, 2011, all of which are herebyincorporated by reference in their entirety.

BACKGROUND

The subject technology generally relates to dental implants.

Implant dentistry involves the restoration of one or more teeth in apatient's mouth using artificial components. Such artificial componentstypically include an implant body, an abutment, and a crown. Thecompleted assembly is referred to as a dental implant.

The implant body is the part of the dental implant that provides theanchor or foundation for the restoration. This part is fixed in the jawbone, and can be threaded or non-threaded. Bone tissue tends to growaround the implant body and thus the jaw bone is strengthened.Commercially available implant bodies are typically made of eithercommercially pure titanium or a titanium alloy and, depending on theneed, may be coated with hydroxyapatite to promote osseointegration. Theabutment is the portion of the dental implant that attaches to theimplant body and extends above the gumline and provides internal supportto the artificial crown. The crown is the topmost part of therestoration and is the part that is visible in the mouth. Crowns fordental implants are similar to crowns applied over natural teeth and areusually made of metal or porcelain or a mixture of the two. FIGS. 1 and2 illustrate two examples of existing dental implants.

Temporary components used during the implantation procedure include ahealing screw and a healing cap. The healing screw is used after theimplant body is initially placed while the soft tissue over the implantbody is healing. The healing screw facilitates the suturing of the softtissue and also prevents the growth of tissue over the edge of theimplant. A healing cap is a dome-shaped cap that projects through thesoft tissue into the oral cavity and further guide the growth of gumtissues around the implant body.

Generally, the process for restoring a tooth is carried out in foursteps—diagnosis, implantation, attachment of the abutment, andattachment of the crown. During the diagnosis in Step 1, an X-ray imageis typically taken of the patient's head to determine the shape anddensity of the bone structure of the jaw. In certain circumstances, aCAT scan may be required to provide more detailed information about thebone and the location of structures such as sinuses.

Step 2 involves implanting the dental implant into the bone of apatient's jaw. The oral surgeon first accesses the patient's jawbonethrough the patient's gum tissue and removes any remains of the tooth tobe replaced. Next, the specific site in the patient's jaw where theimplant will be anchored is widened by drilling and/or reaming toaccommodate the width of the dental implant to be implanted. Then, thedental implant is inserted into the hole in the jawbone, typically byscrewing, although other techniques are known for introducing theimplant in the jawbone.

The implant itself is typically fabricated from pure titanium or atitanium alloy. Such materials are known to produce osseointegration ofthe fixture with the patient's jawbone. Existing dental implanttypically include a hollow threaded bore through at least a portion ofits body and extending out through its proximal end which is exposedthrough the crustal bone for receiving and supporting the final toothprosthesis and/or various intermediate components or attachments.

After the implant is initially installed in the jawbone, a temporaryhealing screw is secured over the exposed proximal end in order to sealthe internal bore. The patient's gums are then sutured over the implantbody and screw to allow the implant site to heal and to allow desiredosseointegration to occur. Complete osseointegration typically takesanywhere from four to ten months.

Step 3 is shown in FIG. 3A. The surgeon reassesses the implant fixtureby making an incision through the patient's gum tissues. The healingscrew is then removed, exposing the proximal end of the implant, and theabutment is attached to the implant body. Typically, an impression isthen taken of the patient's mouth to accurately record the position andorientation of the implant and abutment within the mouth. Thisimpression is used to create a plaster model or analogue of the mouthand/or the implant site and provides the information needed to fabricatethe prosthetic replacement tooth and any required intermediateprosthetic components. Step 3 is typically completed by attaching ahealing cap to the abutment to control the healing and growth of thepatient's gum tissue around the implant site.

Between step 3 and step 4, a crown is fabricated from the plaster modelcreated in step 3. Step 4 in the restorative process includes removingthe temporary healing cap and attaching the crown to the abutment asshown in FIG. 3B.

SUMMARY

One limitation of current dental implants is that the implant body isaligned vertically, i.e., substantially perpendicularly, under, i.e.deep to, the tooth being replaced. In certain patients, especially apatient with osteoporosis, the bone structure and density immediatelyunder the location of the tooth to be replaced may not be sufficient toprovide adequate attachment to the implant body. In such a situation, itwould desirable to be able to angle the implant body relative to avertical line at the location of the tooth to be replaced.

Another limitation of current dental implants is that the abutmentprojects from the gum sufficient that a healing cap is often necessaryto guide the healing of the gum around the abutment. The healing cap maybe intrusive and present an opportunity for the accumulation of food andplaque that may interfere with proper healing. It would be desirable toavoid having to place an external healing cap over the abutment whileproviding a temporary element through the gum that would allow the gumto heal in this area.

Various exemplary embodiments of a dental implant system that addressesthe above limitations are disclosed herein. The subject technology isillustrated, for example, according to various aspects described below.Various examples of aspects of the subject technology are described asnumbered independent and dependent clauses (1, 2, 3, etc.) forconvenience. These are provided as examples and do not limit the subjecttechnology. It is noted that the features of any of the dependentclauses may be combined alone or in any combination into any of theindependent claims or combined with other dependent claims so as todescribe a particular embodiment.

Clause 1. A dental implant system comprising: a lower implant bodyconfigured to be implanted in bone; an upper implant body configured tocouple to the lower implant body, thereby forming a cavity between theupper and lower implant bodies, the upper implant body comprising anopening to the cavity; and a rotatable, swivelable anchor comprising: abase disposed at least partially within the cavity, the base comprisinga first substantially spherical surface; and a shaft coupled to the baseand extending through the opening.

Clause 2. The dental implant system of clause 1, wherein the lowerimplant body is configured to sustain an insertion torque of at least 20N·cm.

Clause 3. The dental implant system of clause 1, wherein the upperimplant body further comprises an internal surface configured such thatthe first substantially spherical surface is at least partially incontact with the internal surface when the upper and lower implantbodies are coupled together with the base of the anchor disposed withinthe cavity.

Clause 4. The dental implant system of clause 3, wherein the internalsurface comprises a second substantially spherical surface.

Clause 5. The dental implant system of clause 4, wherein the openingpasses through the second substantially spherical surface.

Clause 6. The dental implant system of clause 1, wherein: the lowerimplant body comprises an anti-rotation post configured to project intothe cavity when the upper and lower implant bodies are coupled together;and the base further comprises an anti-rotation cavity configured toengage the anti-rotation post when the base of the anchor is disposedwithin the cavity; and the anti-rotation post and anti-rotation cavityare configured to resist rotation of the anchor about a centerline ofthe lower implant body while allowing rotation of the anchor about axesperpendicular to the centerline.

Clause 7. The dental implant system of clause 6, wherein: theanti-rotation post comprises a hex ball; and the anti-rotation cavitycomprises a hex pocket.

Clause 8. The dental implant system of clause 1, further comprising anabutment configured to couple to the shaft of the anchor.

Clause 9. The dental implant system of clause 8, wherein: the upperimplant body further comprises an external third substantially sphericalsurface; and the abutment comprises a fourth substantially sphericalsurface configured such that the fourth substantially spherical surfaceis at least partially in contact with the third substantially sphericalsurface when the upper and lower implant bodies are coupled togetherwith the base of the anchor disposed within the cavity and the abutmentcoupled to the shaft of the anchor.

Clause 10. The dental implant system of clause 8, wherein: the shaft ofthe anchor comprises threads; and the abutment comprises a nutconfigured to threadingly couple to the shaft of the anchor and therebysecure the abutment in a fixed orientation relative to the upper implantbody.

Clause 11. The dental implant system of clause 10, wherein the nut iscaptive within the abutment.

Clause 12. The dental implant system of clause 1, wherein: the lowerimplant body comprises a first threaded portion; the upper implant bodycomprises a second threaded portion configured to be threadingly coupledto the first threaded portion; and the dental implant system furthercomprises a healing cover configured to be removably coupled to thefirst threaded portion.

Clause 13. The dental implant system of clause 1, wherein the upper andlower implant bodies are configured to be welded together.

Clause 14. The dental implant system of clause 1, further comprising aninstallation tool configured to be removably coupled to the upperimplant body and apply a torque about the centerline of the lowerimplant body.

Clause 15. The dental implant system of clause 14, wherein theinstallation tool is further configured to be removably coupled to theshaft of the anchor.

Clause 16. The dental implant system of clause 1, further comprising aninstallation tool configured to be removably coupled to the abutment andapply a torque about the centerline of the lower implant body.

Clause 17. A method of implanting a dental implant, the methodcomprising the steps of: implanting a dental implant system in a bone,the dental implant system comprising an externally threaded lowerimplant body configured to be implanted in bone, an upper implant bodyconfigured to couple to the lower implant body thereby forming a cavitybetween the upper and lower implant bodies, the upper implant bodycomprising an opening to the cavity, and a rotatable, swivelable anchorcomprising a base disposed at least partially within the cavity, thebase comprising a first substantially spherical surface, and a shaftcoupled to the base and extending through the opening; and coupling anabutment to the shaft of the anchor.

Clause 18. The method of clause 17, further comprising the steps of:coupling a healing cap to the abutment; allowing time for gum tissueadjacent to the bone to heal; and removing the healing cap.

Clause 19. A method of implanting a dental implant, the methodcomprising the steps of: implanting a lower implant body through tissueinto bone; placing an anchor in contact with the lower implant body, theanchor comprising a base that comprises a first substantially sphericalsurface and a shaft extending radially from the base; placing an upperimplant body, having an opening, over the rotatable attachment such thatthe shaft extends through the hole; and coupling the upper implant bodyto the lower implant body.

Clause 20. The method of clause 19, further comprising the steps of:coupling a healing cover to the lower implant body; allowing time forthe bone to couple to the lower implant body; and removing the healingcover from the lower implant body.

Clause 21. A dental implant system comprising: an externally threadedlower implant body configured to be implanted in bone and to sustain atorque of at least 20 Newton-centimeters (N·cm); an upper implant bodyconfigured to couple to the lower implant body, thereby forming a cavitybetween the upper and lower implant bodies, the upper implant bodyhaving an upper opening to the cavity; and a rotatable, swivelableattachment comprising: a substantially spherical member disposed withinthe cavity; and a shaft coupled to the substantially spherical memberand extending from the member through the opening.

Clause 22. The dental implant system of clause 21, wherein theexternally threaded body is configured to sustain an insertion torque ofat least 30 N·cm.

Clause 23. The dental implant system of clause 22, wherein theexternally threaded body is configured to sustain an insertion torque ofat least 50 N·cm.

Clause 24. The dental implant system of clause 21, further comprising anabutment configured to couple to the shaft of the rotatable attachmentand to a prosthetic tooth.

Clause 25. The dental implant system of clause 24, wherein the abutmentcomprises a captive nut configured to threadingly couple to the shaft ofthe rotatable attachment.

Clause 26. A dental implant system comprising: a lower implant bodyconfigured to be implanted in bone; an upper implant body coupled to thelower implant body to form a cavity between the upper and lower implantbodies, the upper implant body having an opening to the cavity; apolyaxial sphere disposed within the cavity and having a radial bore;and an abutment configured to couple to a prosthetic tooth and having aninternal passage; and an attachment element that passes through thepassage, into the radial bore, and couples to the sphere, securing theabutment to the upper implant body.

Clause 27. A method of implanting a dental implant, comprising:implanting a lower implant body in bone; placing a rotatable attachment,having a substantially spherical member and a shaft extending radiallyfrom the member, in contact with the lower implant body; placing anupper implant body, having an opening, over the rotatable attachmentsuch that the shaft extends through the hole; and coupling the upperimplant body to the lower implant body.

Clause 28. The method of clause 27, further comprising coupling anabutment to the shaft, the abutment configured to attach to a prosthetictooth.

Clause 29. A method of implanting a dental implant, the methodcomprising the steps of: implanting a lower implant body in bone;placing a polyaxial sphere having a radial bore in contact with thelower implant body; placing an upper implant body, having an opening,over the polyaxial sphere; coupling the upper implant body to the lowerimplant body; and placing an abutment, having a passage therethrough, incontact with the upper implant body, the abutment configured to attachto a prosthetic tooth.

Clause 30. The method of clause 29, further comprising passing anattachment element through the passage, through the opening, and intothe bore; and coupling the attachment element to the polyaxial sphere.

Clause 31. A dental implant system comprising: a lower implantconfigured to be implanted in bone, the lower implant comprising: anexternally threaded body having a center axis, the body configured tosustain an insertion torque of at least 20 N·cm; and an internal ballcoupled to the body; an upper implant coupled to the lower implant toform a cavity between the upper and lower implants, wherein the internalball is disposed within the cavity, the upper implant having an openingto the cavity; a rotatable attachment comprising: a substantiallyspherical member disposed within the cavity between the upper and lowerimplants, the substantially spherical member comprising a shaped pocketconfigured to accept the internal ball, the internal ball and shapedpocket configured such that the internal ball has restricted rotationrelative to the body about the center axis and can rotate relative tothe body about axes perpendicular to the center axis; and a shaftcoupled to, and extending from, the substantially spherical memberthrough the opening.

Clause 32. The dental implant system of clause 31, wherein theexternally threaded body is configured to sustain an insertion torque ofat least 30 N·cm.

Clause 33. The dental implant system of clause 32, wherein theexternally threaded body is configured to sustain an insertion torque ofat least 50 N·cm.

Clause 34. The dental implant system of clause 31, further comprising anabutment configured to couple to the shaft of the rotatable attachment.

Clause 35. The dental implant system of clause 31, wherein: the lowerimplant and the upper implant are formed as a single unitary implant;and the opening to the cavity is formed in a configuration that allowsthe substantially spherical member of the rotatable attachment to beinserted through the opening into the cavity so as to engage theinternal ball, after which the unitary implant is manipulated to modifythe opening to a configuration that retains the substantially sphericalmember within the cavity.

Clause 36. A dental implant system comprising: a body configured to bepartially implanted in bone, the body comprising: a cavity comprising aninternal surface, a portion of the internal surface being substantiallyspherical; and an opening through the body and within the substantiallyspherical portion of the internal surface, the opening having aperimeter; and an anchor comprising: a base comprising a substantiallyspherical external surface, the base disposed within the cavity with thesubstantially spherical external surface of the base in sealing contactwith the substantially spherical internal surface of the cavity at leastalong the perimeter of the opening; and a shaft coupled to the base andextending from the base through the opening of the body.

Clause 37. The dental implant system of clause 36, wherein: the bodycomprises a first anti-rotation feature with an axis; the firstanti-rotation feature is disposed within the cavity of the body; and thebase of the anchor comprises a second anti-rotation feature configuredto cooperate with the first anti-rotation feature when the anchor isdisposed within the cavity; the first and second anti-rotation featuresare configured to cooperatively resist rotation of the base relative tothe body about the axis of the first anti rotation feature whileallowing rotation of the base relative to the body about axes that areperpendicular to the axis of the first anti rotation feature.

Clause 38. The dental implant system of clause 37, wherein: the firstanti-rotation feature comprises a post; the second anti-rotation featurecomprises an anti rotation cavity; at least a portion of the post isdisposed within the anti rotation cavity.

Clause 39. The dental implant system of clause 38, wherein: the postcomprises a plurality of curved features arranged symmetrically aboutthe axis; the anti-rotation cavity comprises a plurality ofsymmetrically arranged curved features; the curved features of the postare disposed within the curved features of the anti-rotation cavity.

Clause 40. The dental implant system of clause 39, wherein the post andcavity each comprise six substantially cylindrical features arranged ina hexagonal configuration.

Clause 41. The dental implant system of clause 36, wherein the bodycomprises: a lower body configured to be implanted in bone; and an upperbody coupled to the lower body; wherein the upper body and lower bodycooperate to form the cavity.

Clause 42. A dental implant tool comprising: a body having a cavity at aproximal end, the cavity configured to engage a dental implant thatcomprises: a cavity comprising an internal surface, a portion of theinternal surface being substantially spherical; and an opening throughthe body and within the substantially spherical portion of the internalsurface, the opening having a perimeter; and an anchor comprising: abase comprising a substantially spherical external surface, the basedisposed within the cavity with the substantially spherical externalsurface of the base in sealing contact with the substantially sphericalinternal surface of the cavity at least along the perimeter of theopening; and a shaft coupled to the base and extending from the basethrough the opening of the body.

Clause 43. The dental implant tool of clause 42, wherein the bodyfurther comprises a torque feature at a distal end opposite the proximalend, the torque feature configured to engage a torque-applying tool.

Clause 44. The dental implant tool of clause 42, further comprising anattachment element that passes through the body from the distal endtoward the proximal end, the attachment element configured to engage theanchor of the dental implant.

Clause 45. A dental implant tool comprising: a body having a cavity at aproximal end, the cavity configured to engage an abutment of a dentalimplant, the dental implant further comprising: a cavity comprising aninternal surface, a portion of the internal surface being substantiallyspherical; and an opening through the body and within the substantiallyspherical portion of the internal surface, the opening having aperimeter; and an anchor comprising: a base comprising a substantiallyspherical external surface, the base disposed within the cavity with thesubstantially spherical external surface of the base in sealing contactwith the substantially spherical internal surface of the cavity at leastalong the perimeter of the opening; and a shaft coupled to the base andextending from the base through the opening of the body.

Clause 46. The dental implant tool of clause 45, further comprising animplant nut disposed within the abutment, the implant nut configured toengage the shaft of the anchor.

Clause 47. A dental implant system comprising: a body configured to bepartially implanted in bone, the body comprising: a cavity comprising aninternal surface, a portion of the internal surface being substantiallyspherical; and an opening through the body and within the substantiallyspherical portion of the internal surface, the opening having aperimeter; and an anchor comprising: a base comprising a substantiallyspherical external surface, the base disposed within the cavity with thesubstantially spherical external surface of the base in sealing contactwith the substantially spherical internal surface of the cavity at leastalong the perimeter of the opening; and a shaft coupled to the base andextending from the base through the opening of the body; an abutmentcomprising a generally cylindrical cavity with a bottom and a side wall,the bottom comprising an external surface having a portion that issubstantially spherical, the abutment further comprising a hole throughthe bottom that is configured to fit over the portion of anchor shaftthat extends through the opening in the body; and a nut disposed withinthe cavity of the abutment and configured to engage at least a portionof the anchor shaft that extends through the opening in the body.

Clause 48. The dental implant system of clause 47, further comprising ahealing cap configured to snap onto an abutment and ride against the topof the abutment.

Clause 49. The dental implant system of clause 47, wherein the anchorfurther comprises an anti-rotation feature configured to cooperate witha mating feature of the base to resist rotation of the anchor about acenter axis of the base.

Clause 50. A method of providing a replacement tooth to a patient, themethod comprising the step of: implanting a positionable dental implantinto a jaw bone of the patient in an approximate surface location of thetooth that is being replaced, wherein the positionable dental implantcomprises a base and an abutment, wherein the base comprises apositionable anchor comprising an anti-rotation feature that cooperateswith a mating feature of the base to resist rotation of the anchor abouta center axis of the base and a shaft that projects through a hole inthe base, and wherein the abutment is releasably secured to the shaft ofthe anchor.

Clause 51. The method of clause 49, further comprising the step of:securing a healing cap over the abutment with an interior surface of thehealing cap in contact with a top surface of the abutment.

Clause 52. The method of clause 49, wherein the step of implanting thepositionable dental implant comprises the step of: implanting the baseinto the jaw bone at an angle to a center axis of the tooth that isbeing replaced so the base is in contact with a strongest portion of thejaw bone that is within the reach of the implant from the surfacelocation of the tooth that is being replaced.

Clause 53. The method of clause 50, wherein the step of implanting thepositionable dental implant further comprises the step of: adjusting theposition of the abutment so that a central axis of the abutment isgenerally parallel to the center axis of the tooth that is beingreplaced.

Clause 54. The method of clause 51, wherein the step of adjusting theposition of the abutment comprises the steps of: loosening a nut that isdisposed within a cavity of the abutment and configured to engage theshaft of the positionable anchor thereby securing the abutment to thebase; repositioning the anchor so that the central axis of the abutmentis generally parallel to the center axis of the tooth that is beingreplaced; and tightening the nut.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are included to provide furtherunderstanding and are incorporated in and constitute a part of thisspecification, illustrate disclosed embodiments and together with thedescription serve to explain the principles of the disclosedembodiments. In the drawings:

FIG. 1 is a cut-way illustration of an example of an existing dentalimplant.

FIG. 2 is a cross-section of a natural tooth and a second example of anexisting dental implant.

FIG. 3A illustrates a portion of the steps in a portion of an exampleexisting implantation process.

FIG. 3B illustrates a crown being attached to a abutment FIG. 1 in anexample existing implantation process.

FIGS. 4A and 4B are perspective and cross-sectional views, respectively,of an exemplary positional dental implant according to certain aspectsof this disclosure.

FIGS. 5A and 5B are perspective and cross-sectional views, respectively,of a portion of the positional dental implant of FIGS. 4A and 4Baccording to certain aspects of this disclosure.

FIGS. 6A and 6B are perspective and cross-sectional views, respectivelyof another exemplary positional dental implant according to certainaspects of this disclosure.

FIG. 7 is a perspective view of a portion of the positionable dentalimplant of FIGS. 6A and 6B according to certain aspects of thisdisclosure.

FIGS. 8A-8C are cross-sections of stages in an exemplary implantationaccording to certain aspects of this disclosure.

FIG. 8D is a cross-section illustrating an alternate implantationconfiguration according to certain aspects of this disclosure.

FIGS. 9A-9C illustrate another embodiment of a positionable dentalimplant according to certain aspects of this disclosure.

FIG. 10 depicts another embodiment of the implantable portion of apositionable dental implant according to certain aspects of thisdisclosure.

FIG. 11 depicts the positionable dental implant of FIG. 9A implanted ina patient's jaw according to certain aspects of this disclosure.

FIGS. 12A-12C depict another embodiment of a positionable dental implantaccording to certain aspects of this disclosure.

FIGS. 13A-13B depict details of the anchor of FIGS. 12A-12C according tocertain aspects of this disclosure.

FIGS. 14A-14B depict details of the lower implant of FIGS. 12A-12Caccording to certain aspects of this disclosure.

FIGS. 15A-15B depict perspective and cross-section views, respectively,of a T1 tool according to certain aspects of this disclosure.

FIGS. 16A-16B depict perspective and cross-section views, respectively,of a T2 tool according to certain aspects of this disclosure.

FIGS. 17A-17B depict perspective and cross-section views, respectively,of a T3 tool according to certain aspects of this disclosure.

FIGS. 18A-18B depict perspective and cross-section views, respectively,of a T4 tool according to certain aspects of this disclosure.

FIGS. 19A-19B depict perspective and cross-section views, respectively,of a T5 tool according to certain aspects of this disclosure.

FIGS. 20A-20B depict perspective and cross-section views, respectively,of a healing cap according to certain aspects of this disclosure.

FIGS. 21A-21B depict perspective and cross-section views, respectively,of another embodiment of a positionable dental implant according tocertain aspects of this disclosure.

DETAILED DESCRIPTION

The following description discloses embodiments of a positionable dentalimplant and method of implantation.

In the following detailed description, numerous specific details are setforth to provide a full understanding of the present disclosure. It willbe apparent, however, to one ordinarily skilled in the art thatembodiments of the present disclosure may be practiced without some ofthe specific details. In other instances, well-known structures andtechniques have not been shown in detail so as not to obscure thedisclosure.

The method and system disclosed herein are presented in terms of adental implant used to replace a tooth for a human being. It will beapparent to those of ordinary skill in the art that these systems andmethods may be applied in other applications such as veterinarymedicine. Nothing in this disclosure, unless specifically stated, shouldbe interpreted as limiting the disclosed systems and methods to thespecific examples used herein.

Within this disclosure, the term “substantially spherical” refers to atwo- or three-dimensional contour that does not necessarily imply aperfectly spherical shape. Rather, substantially spherical structuresdescribed herein may be substantially or partially spherical in shape,have substantially circular or elliptical cross-sections, and/or haveopenings, indentations, defects, or aberrations in shape withoutdeparting from the substance of the subject technology.

Within this disclosure, the term “substantially spherical surface” meansthat the surface has a one of more portions that share a commonsubstantially spherical contour. The surface may be continuous or havegrooves or recesses such that portions of the surface share the contourbut are not continuous. The term “substantially spherical surface” doesnot imply that the surface subtends all or any particular portion of asphere.

Within this disclosure, the term “substantially embedded” means that aportion of one item is embedded within a second item sufficient tofulfill an intended purpose. In some aspects, a majority of the firstitem may be embedded in the second item. In some aspects, for exampleattachment, only enough of the first object required to provide adequateattachment to the second item is embedded in the second item. In someaspects, a portion of the first item may protrude from the second item.

FIG. 1 is a cut-way illustration of an example of an existing dentalimplant. The dental implant is shown in the position in which it wouldbe implanted to replace the center tooth.

FIG. 2 is a cross-section of a natural tooth and a second example of anexisting dental implant. The natural tooth structure is shown on theleft and an example existing dental implant is shown on the right. Thisexample dental implant has a threaded implant body and a cylindricalabutment that is screwed into a threaded recess (not visible) on the topof in the implant body. FIG. 2 also illustrates the position of the boneand gum around this example implant.

FIG. 3A illustrates a portion of the steps in a portion of an exampleexisting implantation process. The first picture is the state of thepatient after the healing period has elapsed after the implant body wasplaced in the jaw. The second picture illustrates removal of the gumtissue overlying the implant using a tool, and the third picture is theremoval of the temporary healing screw. The fourth picture illustratesinstallation of an abutment using a tool, and the fifth pictureillustrates an installed healing cap over the abutment and gums.

FIG. 3B illustrates a crown being attached to a abutment FIG. 1 in anexample existing implantation process. In this example, the abutment isa simple pin and the crown has a matching recess (not visible) which isbonded to the pin.

FIGS. 4A and 4B are perspective and cross-sectional views, respectively,of an exemplary positional dental implant according to certain aspectsof this disclosure. The following features are identified in FIGS. 4A,4B, 5A, and 5B.

REF. IDENTIFIER FEATURE

-   1 Upper implant-   2 Lower implant-   3 Abutment-   4 Abutment inclination angle (alpha)-   5 Lower implant centerline-   6 Abutment centerline-   7 Abutment rotation angle (beta)-   8 upper implant scarf-   9 threaded installation feature-   10 Thread-cutting groove-   11 third substantially spherical surface-   13 Abutment scarf-   14 second substantially spherical surface-   15 first substantially spherical surface-   16 Attachment interface-   17 Polyaxial sphere-   18 Flexure-   19 fourth substantially spherical surface-   22 attachment stop surfaces-   24 Hexagonal recess-   25 Fastener-   26 Keeper groove-   27 Keeper-   29 positionable dental implant

In certain embodiments, the lower implant body 2 is installed into thebone of a patient prior to assembly with the upper implant body 1. Aninstallation tool (not shown in FIG. 4A) may be removable coupled to thelower implant body 2 and manipulated such that the lower implant body isinserted through the gum tissue of a patient and into the jaw bone. Incertain embodiments, this installation includes the rotation of thelower implant body about axis 5 such that the external threads of thelower implant body 2 engage the bone. In certain embodiments, athread-cutting groove 10 assists in cutting threads into the bone toassist in the implantation. In certain embodiments, a torque is appliedto the lower implant body 2 to rotate the lower implant body as it isimplanted into the bone. In certain embodiments, the lower implant body2 is configured to withstand an installation torque of up to 20newton-centimeters (N·cm). In certain embodiments, the lower implantbody 2 is configured to withstand an installation torque of up to 30N·cm. In certain embodiments, the lower implant body 2 is configured towithstand an installation torque of up to 50 N·cm.

In certain embodiments, the upper and lower implant bodies 1 and 2 areassembled prior to implantation of the lower implant body 2 into thebone of the patient. In certain embodiments, the upper and lower implantbodies 1 and 2 are coupled with threads. In certain embodiments, theupper implant body 1 is tightened onto the lower implant body 2 untilthe attachment stop surfaces 22 touch.

When the upper implant body 1 is coupled to the lower implant body 2, aflexure 18 is placed on the lower implant body 2, then a polyaxialsphere 17 is placed on the flexure 18 and the upper implant body 1placed over the polyaxial sphere 17 and coupled to the power implantbody 2. The flexure 18 applies a force to the polyaxial sphere 17 thatplaces the first substantially spherical surface 15 in at least partialcontact with the second substantially spherical surface 19. In thisembodiment, the polyaxial sphere 17 is free to rotate away the axis 5,shown as an angle 4, also referred to as the ‘alpha angle,’ and rotateabout the axis 6, also referred to as the ‘beta angle,’ which is alsoaligned with the attachment interface 16.

FIG. 4B illustrates an exemplary embodiment wherein abutment 3 isattached to the polyaxial sphere 17 with a fastener 25. In certainembodiments, the attachment 25 is a socket bolt having a hexagonalrecess 24 that is used with a tool, such as a hex wrench (not shown inFIG. 4B, to tighten the fastener 25 to the polyaxial sphere 17.

FIGS. 5A and 5B are perspective and cross-sectional views, respectively,of a portion of the positional dental implant 29 of FIGS. 4A and 4Baccording to certain aspects of this disclosure.

FIG. 5B illustrates a threaded installation feature 9 used, in certainembodiments, to enable attachment of an installation tool to the lowerimplant body 2. In certain embodiments, the attachment feature 16 is thesame or larger than installation feature 9 such that a tool may passthrough the attachment feature 16 to reach the installation feature 9and thus allow installation of the assembled upper and lower implantbodies 1 and 2.

FIGS. 6A and 6B are perspective and cross-sectional views, respectivelyof another exemplary positional dental implant 41 according to certainaspects of this disclosure. The upper implant 32 and the lower implant30 are similar to the upper and lower implants 1, 2 of FIGS. 4A and 4B.In this implant 41, a positionable anchor 43 comprises a base 34 that iscaptured between the upper and lower implants 32, 30 and a shaft 42 thatis coupled to the base 34 and extends along a radial axis from the base34. The anchor 43 is able to rotate and turn over a conical regiondefined by the movement of the shaft 42 within an opening 38 of theupper implant 32. In certain embodiments, the abutment 36 comprises athreaded bore 40 and the shaft 42 has a matching set of threads suchthat the abutment 36 may be screwed onto the threaded shaft 42. Theangular position of the anchor 43 becomes fixed when the abutment 36 istightened onto shaft 42.

FIG. 7 is a perspective view of a portion of the positional dentalimplant of FIGS. 6A and 6B according to certain aspects of thisdisclosure. It can be seen how the shaft 42 can rotated as limited bythe opening 38 of the upper implant 32.

FIGS. 8A-8C are cross-sections of stages in an exemplary implantationprocess according to certain aspects of this disclosure. FIG. 8A showsthe lower implant 30 placed through the gum tissue 62 and into the jawbone 60 of a patient. In this embodiment, the lower implant 30 isoriented vertically under the location of the tooth to be replaced. Itcan be seen that, in this embodiment, the top of the lower implant 30 isrecessed from the surface of the bone 60. In certain embodiments, thetop of the lower implant 30 is flush with the surface of the bone 60. Ahealing cover 50 has been placed over the lower implant 30. In certainembodiments, the lower implant 30 comprises a first threaded portion andthe healing cover 50 is configured to be removably coupled to the firstthreaded portion of the lower implant 32. In certain embodiments, thegum 62 is sutured over the healing cover 50.

In FIG. 8B, some gum tissue 62 and the healing cover 50 have beenremoved and an anchor 34 and upper implant 32 installed. The anchor isrotated to provide the desired angle of the tooth crown (not shown inFIG. 8B) that is to be attached. A healing cap 52 is installed over thethreaded shaft 42. In certain embodiments, the step shown in FIG. 8B isomitted.

In FIG. 8C, the healing cap 52 has been removed and an abutment 36 hasbeen coupled to the shaft 42. The lower spherical interface of theabutment 36, corresponding to the fourth substantially spherical surface19 of the abutment 3 of FIG. 4B, mates with the top spherical surface ofthe upper implant 32, corresponding to the third substantially sphericalsurface 11 of the upper implant body 1 of FIG. 4B.

FIG. 8D is a cross-section illustrating another embodiment of animplantation configuration according to certain aspects of thisdisclosure. In this embodiment, the lower implant 30 has been implantedat an angle to a vertical axis 70 located under the location of thetooth to be replaced. This allows the lower implant 30 to be placed, forexample, into a region of the jaw where the bone 60 is denser. It can beseen that the rotational capability of the anchor 34 relative to thelower implant 30 allows the abutment 36 to be placed in the sameposition as in FIG. 8C despite the difference in the position of thelower implant 30.

FIGS. 9A-9C illustrate another embodiment 100 of a positionable dentalimplant according to certain aspects of this disclosure. The followingelements are identified in FIGS. 9A-9C.

REF. IDENTIFIER FEATURE

-   5 axis of the lower implant body-   6 axis of the abutment-   38 Implant thread form-   39 Reduced area of abutment-   41 portion of upper implant body wherein the surface is abraded for    osteoblast-   42 Abutment-   43 Captive nut-   44 Anchor-   45 upper implant scarf-   46 Implant assembly (includes 44, 47, 49)-   47 Lower implant body-   48 shaft-   49 Upper implant body-   50 first substantially spherical surface-   51 Flexure-   52 abutment scarf-   53 retaining clip-   54 hexagonal recess-   55 groove-   56 second substantially spherical surface-   100 dental implant

In this embodiment, the abutment 42 comprises a captive locking nut 43that is captured by a retaining clip 53 that engages a groove 55 formedin the abutment 42. In certain embodiments, the nut 43 comprises ahexagonal recess 54 that allows use of a tool (not shown) to tighten thenut 43 onto the shaft 44. Flexure 51 provides constant contact pressurebetween the first substantially spherical surface 50 of anchor 43 andthe second substantially spherical surface 56.

FIG. 10 depicts another embodiment of the implantable portion of apositionable dental implant 100 according to certain aspects of thisdisclosure. The following elements are identified in FIG. 10 in additionto elements previously identified.

60 Non-rotating anchor

62 anti-rotation cavity

64 Hex ball

66 anti-rotation post

68 Non-rotating lower implant body

70 Hex cavity

72 axis of anti-rotation post

The anti-rotation post 66 comprises a hex ball 64 fits into theanti-rotation cavity 62 in the non-rotating anchor 60 such that theanchor 60 cannot rotate relative to the lower implant 68 about the axis72 but can rotate about axes perpendicular to axis 72. In certainembodiments, the axis 72 is coincident with the centerline 37 of thelower implant body 68. The hex ball shaft 66 has a straight hex profilethat matches the hex cavity 70 of lower implant 68 such that theanti-rotation post 66 cannot rotate relative to the lower implant body68.

In certain embodiments, the hex ball 64 and anti-rotation cavity 62 eachhave six facets configured to engage each other. In certain embodiments,the facets of the hex ball 64 are curved about an axis perpendicular toaxis 72. In certain embodiments, the hex ball 64 and anti-rotationcavity 62 have a common number of facets that is different from six.

FIG. 11 depicts the positionable dental implant 100 of FIG. 9A implantedin a patient's jaw according to certain aspects of this disclosure. Theupper portion 36A of the abutment 36 is configured to accept a crown 74.In certain embodiments, portion 36B is configured to be substantiallyembedded in the tissue 62 of the patient. In certain other embodiments,the implant assembly 46 is implanted at a greater depth, while incertain other embodiments, the implant assembly 46 is implanted at alesser depth. In certain embodiments, the implant assembly 46 isimplanted with the alpha axis 37 at an angle to the vertical (as seen inFIG. 11) similar to FIG. 8D. In certain embodiments, the elements ofFIG. 10 replace the like elements of FIGS. 9A-9B.

FIGS. 12A-12C depict another embodiment 101 of a positionable dentalimplant according to certain aspects of this disclosure. FIG. 12Adepicts an external view of the assembled dental implant 101 with asection line B-B.

FIG. 12B is a cross-section along the section line B-B of FIG. 12A.Dental implant 101 includes a lower implant 105 having a body 106 and ananti-rotation post 107, an upper implant 110, and a positionable anchor120 having a threaded shaft 122 and a base 126 with an anti-rotationcavity 124. In this embodiment, the upper implant 110 is electron-beamwelded to the lower implant 105 prior to implantation in the patient'sjaw. The area indicated by the broken-line circle labeled ‘12C’ isenlarged in FIG. 12C.

FIG. 12C is an enlarged portion of FIG. 12B wherein the anchor 120includes a base 126 having a spherical interface surface 127. Upperimplant 110 has an internal interface 111 that is substantiallyspherical. When assembled, and after an abutment (not shown) istightened onto the threaded body 122, the spherical interface surface127 of the anchor 120 is in contact with the spherical interface surface111 of the upper implant 110. This contact between surfaces 127 and 11forms a continuous seal along a perimeter 130 around the edge of theopening 112 in the upper implant 110. This continuous seal resistsdebris and bacteria from entering the internal volume 140 formed withindental implant 100. Accumulation of debris, such as liquid or solidfood, in a recess where bacteria can multiple and not be easily removedin normal oral care creates a risk of infection for the patient.Providing a continuous seal along perimeter 130 reduces this risk.

FIGS. 13A-13B depict details of the anchor of FIGS. 12A-12C according tocertain aspects of this disclosure. FIG. 13A is a cross-section of theanchor 120 showing the anti-rotation cavity 124. FIG. 13B is an end viewfrom the anti-rotation cavity 124 in which it can be seen that, in thisembodiment, the cavity 124 has a hexagonal profile.

FIGS. 14A-14B depict details of the lower implant of FIGS. 12A-12Caccording to certain aspects of this disclosure. FIG. 14A is across-section of a portion of the lower implant 105 showing theanti-rotation post 107. FIG. 14B is an end view from the anti-rotationpost 107 in which it can be seen that, in this embodiment, the post 107has a hexagonal profile. In certain aspects, the dimensions of the post107 and the cavity 124 are selected such that the post 107 has clearancewithin the cavity 124. In certain aspects, the post 107 and cavity 124are fabricated such that there is effectively zero clearance, i.e. lessthan 0.001 inches, between the two when assembled.

When the dental implant 100 is assembled as shown in FIGS. 12A-12B, thehexagonal features of this embodiment of the post 107 are disposedwithin the hexagonal features of the this embodiment of the cavity 127.In this configuration, the anchor 120 is free to tilt with respect tothe upper and lower implant 110, 105, i.e. rotate about axes that areperpendicular to the axis 101 shown in FIG. 12B. The hexagonal featuresof post 107 cooperate with the hexagonal features of the cavity 127 toresist rotation of anchor 120 relative to the upper and lower implant110, 105 about the axis 101. In certain embodiments, the maximumdimension of an aspect the post 107, such as the width of the flatsacross the hexagon, and the minimum dimension of the correspondingaspect of the cavity 127 are selected to be identical to minimize theclearance between the post 107 and cavity 127.

FIGS. 15A-15B depict perspective and cross-section views, respectively,of a T1 insertion tool 150 according to certain aspects of thisdisclosure. The tool 150 is adapted for installation of a dental implant100, or similar, when the abutment 42 is not attached. The tool 150comprises an outer tube 152 that is configured to engage the outersurface of the upper implant 49 and an inner shaft 154 that isconfigured to engage the shaft 48 of the anchor 44. Tightening the upperknob 155 pulls the anchor 44 upward against the inner surface 56 of theupper implant body 49 thereby locking the orientation of the tool 150with respect to the lower implant body 47. Torque can then be applied tothe flats 156 of the tool 150 to implant the lower implant 47 into thejawbone.

FIGS. 16A-16B depict perspective and cross-section views, respectively,of a T2 insertion tool 160 according to certain aspects of thisdisclosure. The tool 160 adapted for installation when the abutment 42is not attached. The tool 160 comprises a shaft 162 having a firstcavity that is configured to engage the upper implant body 49 and theupper implant scarf 45 such that the tool 160 can apply torque to theimplant 100. In certain aspects, the implant 100 is free to fall out ofthe cavity 164. In certain aspects, a retention feature (not shown inFIG. 16A or 16B), for example an o-ring partially embedded in a wall ofthe cavity 164, provides retention force to retain the implant 100within the cavity 164. A second cavity 166 provides space for the shaft44 but does not engage the shaft 44.

FIGS. 17A-17B depict perspective and cross-section views, respectively,of a T3 insertion tool 170 according to certain aspects of thisdisclosure. The tool 170 is adapted to engage the implant 100 in amanner similar to tool 160. Tool 170 comprises a series of torquingflats 176 and a retention feature 174, in this example an o-ring, toprevent the tool 170 from falling out of the device (not shown) applyingtorque to the torquing flats 176.

FIGS. 18A-18B depict perspective and cross-section views, respectively,of a T4 tool 180 according to certain aspects of this disclosure. Thetool 180 is adapted for installation when the abutment 42 is attachedand the captive nut 43 tightened. The tool 180 comprises a shaft 182 anda cavity 184 configured to engage the outside surface of the abutment 42and the abutment scarf 52. In certain aspects, the implant 100 is freeto fall out of the cavity 184.

FIGS. 19A-19B depict perspective and cross-section views, respectively,of a T5 tool 190 according to certain aspects of this disclosure. Thetool 190 is adapted to engage the implant 100 in a manner similar totool 180. Tool 190 comprises a series of torquing flats 196 and aretention feature 194, in this example an o-ring, to prevent the tool190 from falling out of the device (not shown) applying torque to thetorquing flats 196.

FIGS. 20A-20B depict perspective and cross-section views, respectively,of a healing cap 200 according to certain aspects of this disclosure.The cap 200 snaps onto an abutment 42 and rides against the top of theabutment 42. In certain embodiments, the cap 200 comprises a clip edge202 configured to engage the ridge of the abutment 42.

FIGS. 21A-21B depict perspective and cross-section views, respectively,of another embodiment of a positionable dental implant 210 according tocertain aspects of this disclosure. In this embodiment, a upper implantbody 212 and lower implant body 214 are configured similar to the upperand lower implant bodies 47 and 439 of implant 100, shown in FIG. 9A,except that upper and lower implant bodies 212 and 214 are welded alongthe seam 216. In certain aspects, the upper and lower implant bodies 212and 214 are e-beam welded. In certain aspects, the upper and lowerimplant bodies 212 and 214 are continuously welded. In certain aspects,the upper and lower implant bodies 212 and 214 are intermittentlywelded.

The concepts disclosed herein provide a system and method forimplantation of an implant body at an angle from a vertical axis underthe location of a tooth to be replaced. The angular installation allowsthe implant body to be placed so as to improve the strength and healingof the dental implant in the jaw bone while retaining the ability toposition the abutment, and therefore the crown, in the natural toothorientation.

The previous description is provided to enable a person of ordinaryskill in the art to practice the various aspects described herein. Whilethe foregoing has described what are considered to be the best modeand/or other examples, it is understood that various modifications tothese aspects will be readily apparent to those skilled in the art, andthe generic principles defined herein may be applied to other aspects.Thus, the claims are not intended to be limited to the aspects shownherein, but is to be accorded the full scope consistent with thelanguage claims, wherein reference to an element in the singular is notintended to mean “one and only one” unless specifically so stated, butrather “one or more.” Unless specifically stated otherwise, the terms “aset” and “some” refer to one or more. Pronouns in the masculine (e.g.,his) include the feminine and neuter gender (e.g., her and its) and viceversa. Headings and subheadings, if any, are used for convenience onlyand do not limit the invention.

It is understood that the specific order or hierarchy of steps in theprocesses disclosed is an illustration of exemplary approaches. Basedupon design preferences, it is understood that the specific order orhierarchy of steps in the processes may be rearranged. Some of the stepsmay be performed simultaneously. The accompanying method claims presentelements of the various steps in a sample order, and are not meant to belimited to the specific order or hierarchy presented.

Terms such as “top,” “bottom,” “front,” “rear” and the like as used inthis disclosure should be understood as referring to an arbitrary frameof reference, rather than to the ordinary gravitational frame ofreference. Thus, a top surface, a bottom surface, a front surface, and arear surface may extend upwardly, downwardly, diagonally, orhorizontally in a gravitational frame of reference.

A phrase such as an “aspect” does not imply that such aspect isessential to the subject technology or that such aspect applies to allconfigurations of the subject technology. A disclosure relating to anaspect may apply to all configurations, or one or more configurations. Aphrase such as an aspect may refer to one or more aspects and viceversa. A phrase such as an “embodiment” does not imply that suchembodiment is essential to the subject technology or that suchembodiment applies to all configurations of the subject technology. Adisclosure relating to an embodiment may apply to all embodiments, orone or more embodiments. A phrase such an embodiment may refer to one ormore embodiments and vice versa.

The word “exemplary” is used herein to mean “serving as an example orillustration.” Any aspect or design described herein as “exemplary” isnot necessarily to be construed as preferred or advantageous over otheraspects or designs.

All structural and functional equivalents to the elements of the variousaspects described throughout this disclosure that are known or latercome to be known to those of ordinary skill in the art are expresslyincorporated herein by reference and are intended to be encompassed bythe claims. Moreover, nothing disclosed herein is intended to bededicated to the public regardless of whether such disclosure isexplicitly recited in the claims. No claim element is to be construedunder the provisions of 35 U.S.C. §112, sixth paragraph, unless theelement is expressly recited using the phrase “means for” or, in thecase of a method claim, the element is recited using the phrase “stepfor.” Furthermore, to the extent that the term “include,” “have,” or thelike is used in the description or the claims, such term is intended tobe inclusive in a manner similar to the term “comprise” as “comprise” isinterpreted when employed as a transitional word in a claim.

1. A dental implant system comprising: a lower implant body configuredto be implanted in bone; an upper implant body coupled to the lowerimplant body, thereby forming a cavity between the upper and lowerimplant bodies, the upper implant body comprising an internal surfaceand an opening to the cavity, the opening having a perimeter; and arotatable, swivelable anchor comprising: a base disposed at leastpartially within the cavity, the base comprising a first substantiallyspherical surface in contact with the perimeter of the opening so as toform a continuous seal along the perimeter of the opening between thebase and the upper implant body; and a shaft coupled to the base andextending through the opening; and a flexure disposed within the cavityand configured (a) to urge the base toward the upper implant body suchthat the first substantially spherical surface is at least partially incontact with the internal surface upon coupling the upper implant bodyto the lower implant body with the base of the anchor disposed withinthe cavity and (b) to maintain the first substantially spherical surfacein contact with the perimeter of the opening during a tooth restorationprocess.
 2. The dental implant system of claim 1, wherein the lowerimplant body is configured to sustain an insertion torque of at least 20N·cm.
 3. (canceled)
 4. The dental implant system of claim 1, wherein theinternal surface comprises a second substantially spherical surface. 5.The dental implant system of claim 4, wherein the opening passes throughthe second substantially spherical surface.
 6. (canceled)
 7. (canceled)8. The dental implant system of claim 1, further comprising an abutmentconfigured to couple to the shaft of the anchor.
 9. The dental implantsystem of claim 8, wherein: the upper implant body further comprises anexternal third substantially spherical surface; and the abutmentcomprises a fourth substantially spherical surface configured such thatthe fourth substantially spherical surface is at least partially incontact with the third substantially spherical surface when the upperand lower implant bodies are coupled together with the base of theanchor disposed within the cavity and the abutment coupled to the shaftof the anchor.
 10. The dental implant system of claim 8, wherein: theshaft of the anchor comprises threads; and the abutment comprises a nutconfigured to threadingly couple to the shaft of the anchor and therebysecure the abutment in a fixed orientation relative to the upper implantbody.
 11. The dental implant system of claim 10, wherein the nut iscaptive within the abutment.
 12. The dental implant system of claim 1,wherein: the lower implant body comprises a first threaded portion; theupper implant body comprises a second threaded portion configured to bethreadingly coupled to the first threaded portion; and the dentalimplant system further comprises a healing cover configured to beremovably coupled to the first threaded portion.
 13. The dental implantsystem of claim 1, wherein the upper and lower implant bodies areconfigured to be welded together.
 14. The dental implant system of claim1, further comprising an installation tool configured to be removablycoupled to the upper implant body and apply a torque about thecenterline of the lower implant body.
 15. The dental implant system ofclaim 14, wherein the installation tool is further configured to beremovably coupled to the shaft of the anchor.
 16. The dental implantsystem of claim 1, further comprising an installation tool configured tobe removably coupled to the abutment and apply a torque about thecenterline of the lower implant body.
 17. (canceled)
 18. (canceled) 19.(canceled)
 20. (canceled)